Dr. Choi....ottitis w/effusion in Japan

[Jaguarjul]

Hi,
    I was diagnosed with ottitis w/effusion in only the right middle ear on Nov. 16th, I began feeling like my ear was abnormal on the 14th, with a feeling of fullness and occassional  discomfort.  I saw an ear, nose & throat specialist and he prescribed antibiotics, mucous thinner and allergy meds (however I don't know their names)-its all in Japanese-I went with a translator.  He had me come back 4 days later and examined my ears again with odoscope and fiberoptic camera.  He said my ear was no longer red and so did not continue the antibiotics.  He gave me four more days of mucous thinner and allergy pills.  I will finish this course tomorrow and my ear still feels like it did in the beginning as far as fullness.  I am especially concerned to heal this health issue as I am scheduled to take a flight on Dec.15 th, and I understand it can be serious to fly w/ ear problems.  
  I have been told by the school nurse where I work that doctors take a very conservative approach with meds hence 4 days of antibiotics - which to me is unheard of in the states.  I have taken antibiotics probably 2 times in the last 12 years.  I do not have a history of sinus infections but I think I have a dust allergy but I don't take meds for it.  When I first arrived I was having some allergies and I was cleaning my sinuses with a warm saline solution - putting it in my nostrils with head tilted back, using a ball syringe and then blowing it out my nostrils-maybe 3 times a week. This seemed to help.   But I haven't done that for over a month.  So it shouldn't be related to the water in my ear.
    I am a 52 year old woman living in Japan since Aug 07 from N. California.  I am a swimmer for 26 years and in very good health and take no medications.  I wear doc earplugs and a silicone cap when I swim.  However, in Japan I have been wearing goggles as they will not let me swim with my full mask which covers my nose.  I think using the goggles is contributing to irritation due to the chlorinated water entering my nose and so has increased allergy reaction in my sinuses.  
  I would appreciate it if Dr. Enoch Choi of Palo Alto would give his opinion as well as any other doctors.  Should I request a more aggressive approach with 7 days of antibiotices, as well as antihistamines or decongestants and/or steroids?  Usually I never take drugs but I want to do what will best heal me before Dec. 15th.  I go back to the doctor this Tuesday the 27th of Nov.
Please advise me.  
Thank You,
Jaguarjul

[Enoch Choi, MD]

Wear/a/Jimmy has a good idea if you absolutely have to fly, you can improve your openness of the eustachian tubes by using afrin nasal spray (oxymetazolone) as long as you don't have hypertension or heart issues.  Don't use afrin more than 3 days, it can be addictive even though it's over the counter.

[Wear/a/Jimmy]

Something else.  There are many antibiotics that stay in the body longer...  Zithromax is a good example. It is a 5 day dose that stays in the body for about 14 days.  We do not know what antibiotic you are on, but it may be something of the same nature.

In my humble opinion your doctor has done a pretty good job for you. I do agree that you will proabably want a follow up before you fly. If you feel that you do not need one, come December, use a nose spray 30-40 minutes prior to flying, just for good measure.

Good luck, and enjoy Japan.

[Enoch Choi, MD]

Doctors are pretty risk adverse and would tell you to take more antibiotics if they thought you needed it

Flying while you still have plugged sensation risks perforating your eardrum, see a doctor before flying.

Great job taking care of yourself.  Ask your doctor if the allergy meds are nasal steroids, those help with your problem of otitis media with effusion (same as serous otitis media).